Monday, May 9, 2011

ADCOM Q&A (working amid diversity)

The western Chicago suburb where I went to high school prides itself on being one of the first "integrated" communities in the country, and on a continued history of diversity. However, if you take a deeper look, you'll quickly see that most of the African-American people live on one side of town, while the Caucasians live on another. And at the high school, African-American and Caucasian people rarely associate with each other. In fact, I caught nasty looks and insults for carpooling with a lovely girl originally from Nigeria (as did she). Maybe you can call this "diversity," but I certainly don't think you can call it "integration."

And so, if an admissions committee member asked me something to the effect of: "What experiences have you had working with diverse populations? What have you learned from those experiences?" the first thing I would do would be to differentiate between "diversity" and "integration." And then I would talk about the experiences I have had with integration - where diverse people really were mixed together and interacted with each other.

My first such experience came when I was a little girl. I grew up in a predominantly African-American church (and when I say predominantly, I mean there were three white families in the whole church) on Chicago's West Side. I still remember the magic of Keystone Baptist Church's amazing choir, how the songs those men and women sang would raise goosebumps on your skin. I remember the passion of the preacher, and the devotion with which deacons prayed. But most of all, I remember the people. We all loved each other deeply, like family, and that love overcame the boundaries of skin color. I remember my mom telling me once that for some of the people in the church, interacting with our family (and the other white families there) was the first and only positive experience they had ever had with white people. And it changed their perspective on skin color.

My own perspective on skin color was that it was irrelevant in terms of status or value. In fact, I thought the dark skin was amazingly beautiful. My favorite babysitter at the time, Felicia, was African American. She was my heroine. One day, my mom found me, black permanent marker in hand, carefully and methodically coloring my skin. "What are you doing?!" she asked, shocked. "I want to look like Felicia," I told her, in a complete matter-of-fact tone, like it should be obvious. My mom was careful to explain that everyone's skin was different, and everyone's skin was beautiful, but that my skin couldn't be dark like Felicia's. She then shuttled a very disappointed daughter to the bath.

What did I learn from these experiences? First, how important it is to instill a sense of respect for diversity and integration into children at a young age, when they are impressionable and willing to learn those lessons. And how important it is to expose them to integrated experiences. Because you can talk all you want, but if you never experience integration, the talk is really meaningless. Second, how important it is to be an ambassador. Because you never know who is watching, and who might take what you say and do seriously.

In addition to my experiences at Keystone with the African-American community, I have spent significant time with the Hispanic community, especially now that I am a Spanish medical translator. Of course in this context, I don't get to know the people on a personal level. But it is an integrated experience nonetheless. Because I am right there, interacting with and speaking with these people in their native language.

One of the most difficult things about my job at the clinic where I work is that medical vocabulary is something you don't use in everyday conversation, so those words have been like a new language I have had to learn on my own. For example, you generally don't talk about IUDs - dispositivos, in case you're wondering - on a daily basis. But you do talk about them when you're translating for a pap smear (papanicolau) appointment.

The second most difficult thing is that the people with whom I work come from so many countries, regions, and backgrounds and hence have different colloquial words and expressions that they use. I remember one time working with a Mexican woman who had injured her shoulder. She kept using a word I had never heard before - I think it was estrellar - and I had no idea what she was saying. Finally, I asked her, "Se rompió el hombro?" - "Did you break your shoulder?" "Sí, sí, sí," she said, smiling and obviously relieved that I had figured out her meaning.

From these experiences, I have learned that sometimes you have to invest a significant amount of time to really be able to integrate yourself into a community and situation, but that the effort is worth it in the end, because you are able to truly make a difference. At the same time, you're never going to get everything perfect - just like how I didn't know what the word estrellar meant at my first go. But when you do make that effort, no matter how imperfect it is, that effort truly is appreciated. So trying is worth it, even if you only know a few words of a language, or a little bit about a culture. Because in trying, you are demonstrating respect for the other person's world. And that makes all the difference.

I'm not trying to paint a rosy picture here. Working in situations where there is diversity (and hopefully integration) can be very difficult, full of misunderstandings, and sometimes even animosity. I only want to share my experiences, what I have learned, and what I hope to bring with me into my future as a physician. Because in that role, I will encounter all kinds of people. And all of them deserve the best of treatment, both medical and personal.